Cerebrospinal fluid proteomics define the natural history of autosomal dominant Alzheimer’s disease
Authors: Erik C. B. Johnson, Shijia Bian, Rafi U. Haque, E. Kathleen Carter, Caroline M. Watson, Brian A. Gordon, Lingyan Ping, Duc M. Duong, Michael P. Epstein, Eric McDade, Nicolas R. Barthélemy, Celeste M. Karch, Chengjie Xiong, Carlos Cruchaga, Richard J. Perrin, Aliza P. Wingo, Thomas S. Wingo, Jasmeer P. Chhatwal, Gregory S. Day, James M. Noble, Sarah B. Berman, Ralph Martins, Neill R. Graff-Radford, Peter R. Schofield, Takeshi Ikeuchi, Hiroshi Mori, Johannes Levin, Martin Farlow, James J. Lah, Christian Haass, Mathias Jucker, John C. Morris, Tammie L. S. Benzinger, Blaine R. Roberts, Randall J. Bateman, Anne M. Fagan, Nicholas T. Seyfried, Allan I. Levey, Jonathan Vöglein, Ricardo Allegri, Patricio Chrem Mendez, Ezequiel Surace, Sarah B. Berman, Snezana Ikonomovic, Neelesh Nadkarni, Francisco Lopera, Laura Ramirez, David Aguillon, Yudy Leon, Claudia Ramos, Diana Alzate, Ana Baena, Natalia Londono, Sonia Moreno, Christoph Laske, Elke Kuder-Buletta, Susanne Graber-Sultan, Oliver Preische, Anna Hofmann, Kensaku Kasuga, Yoshiki Niimi, Kenji Ishii, Michio Senda, Raquel Sanchez-Valle, Pedro Rosa-Neto, Nick Fox, Dave Cash, Jae-Hong Lee, Jee Hoon Roh, Meghan Riddle, William Menard, Courtney Bodge, Mustafa Surti, Leonel Tadao Takada, V. J. Sanchez-Gonzalez, Maribel Orozco-Barajas, Alison Goate, Alan Renton, Bianca Esposito, Jacob Marsh, Carlos Cruchaga, Victoria Fernandez, Gina Jerome, Elizabeth Herries, Jorge Llibre-Guerra, William Brooks, Jacob Bechara, Jason Hassenstab, Erin Franklin, Allison Chen, Charles Chen, Shaney Flores, Nelly Friedrichsen, Nancy Hantler, Russ Hornbeck, Steve Jarman, Sarah Keefe, Deborah Koudelis, Parinaz Massoumzadeh, Austin McCullough, Nicole McKay, Joyce Nicklaus, Christine Pulizos, Qing Wang, Sheetal Mishall, Edita Sabaredzovic, Emily Deng, Madison Candela, Hunter Smith, Diana Hobbs, Jalen Scott, Peter Wang, Xiong Xu, Yan Li, Emily Gremminger, Yinjiao Ma, Ryan Bui, Ruijin Lu, Ana Luisa Sosa Ortiz, Alisha Daniels, Laura Courtney, Charlene Supnet-Bell, Jinbin Xu, John Ringman
Journal: Nature Medicine (2023)

Abstract Alzheimer’s disease (AD) pathology develops many years before the onset of cognitive symptoms. Two pathological processes—aggregation of the amyloid-β (Aβ) peptide into plaques and the microtubule protein tau into neurofibrillary tangles (NFTs)—are hallmarks of the disease. However, other pathological brain processes are thought to be key disease mediators of Aβ plaque and NFT pathology. How these additional pathologies evolve over the course of the disease is currently unknown. Here we show that proteomic measurements in autosomal dominant AD cerebrospinal fluid (CSF) linked to brain protein coexpression can be used to characterize the evolution of AD pathology over a timescale spanning six decades. SMOC1 and SPON1 proteins associated with Aβ plaques were elevated in AD CSF nearly 30 years before the onset of symptoms, followed by changes in synaptic proteins, metabolic proteins, axonal proteins, inflammatory proteins and finally decreases in neurosecretory proteins. The proteome discriminated mutation carriers from noncarriers before symptom onset as well or better than Aβ and tau measures. Our results highlight the multifaceted landscape of AD pathophysiology and its temporal evolution. Such knowledge will be critical for developing precision therapeutic interventions and biomarkers for AD beyond those associated with Aβ and tau.